CMS: Hospice election statements lack required information or have other vulnerabilities

After a stratified random sample review of hospice election statements and certifications of terminal illness, the Office of the Inspector General (OIG) reports that more than one-third of hospice General Inpatient (GIP) stays lack required information or had other vulnerabilities.

Hospice election statements did not always mention – as required – that the beneficiary was waiving coverage of certain Medicare services by electing hospice care or that hospice care is palliative rather than curative

In 14 % of GIP stays, the physician did not meet requirements when certifying that the beneficiary was terminally ill and appeared to have limited involvement in determining that the beneficiary’s condition was appropriate for hospice care

Hospices should improve their election statements and ensure that physicians meet requirements when certifying beneficiaries for hospice care. Resources:

Hospices Should Improve Their Election Statements and Certifications of Illness OIG Report
Hospice Payment System Booklet: Includes a section on the hospice election statement
Documentation Requirements for the Hospice Physician Certification/Recertification MLN Matters Article
Sample Hospice Election Statement MLN Matters Special Edition Article

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